(ch 5; pg 102-129, ATI ch 95 & 96) well
answered to pass
3 phases of period nursing - correct answer ✔✔-1. preoperative (begins when pt and Dr agree
that there's going to be a surgery)
-2. intraoperative (begins with pt leaves preop and transfers to OR)
-3. postoperative (begins when pt is transferred from OR to PACU)
preop nursing - correct answer ✔✔-begins with informed consent
-preop health assessment is performed
-preop health assessment:
-health history is obtained
-physical exam performed
-vitals are noted
-database established for future comparisons
-blood tests, x-rays, and other diagnostic tests are obtained
-preop assessment focuses on prevention of complications:
-1. nutritional and fluid status (factor in promoting healing and resisting infection. any
nutritional deficiency should be corrected before surgery to provide adequate protein for tissue
repair)
-2. drug and alcohol use (if emergency surgery required, local, spinal, or regional block
anesthesia is used for minor surgery. to prevent vomiting and potential aspiration, an NG is
, inserted before general anesthesia is administered. h/o alcoholism often suffer from
malnutrition.)
-3. meds (blood thinners, aspirin. med list to look for drug interactions with anesthesia. OTC
meds important too)
-4. cardiovascular (pacemaker, cardiac function. surgery postponed if uncontrolled
hypertension)
-5. resp status (asthma, COPD. surgery postponed if resp infection is present. smoking
associated with changes in lung function. smoking cessation for 2 days prior)
-6. hepatic and renal function (voiding problems, LFT, clotting abnormalities. optimal function of
liver and urinary system so meds, anesthetic, body waste, and toxins are adequately processed
and removed. surgery contraindicated if pt has acute nephritis, acute renal insufficiency, or
other acute renal problems)
-7. endocrine and immune function (diabetics are at risk for developing high or low BS during
surgery. hypoglycemia during anesthesia or postop from inadequate carbs or excessive insulin.
hyperglycemia may result from stress of surgery, which can increase risk for surgical wound
infection, and fluid/electrolyte loss. thyroid issues. cortic
informed consent - correct answer ✔✔-2 witnesses if pt does not write
-pt will make an "X" where signature should be
-informed consent is:
-necessary before non-emergent surgery can be performed
-primary purpose is to ensure that the pt or pt representative is provided information necessary
to enable them to evaluate the proposed surgery before agreeing to it
-responsibility of surgeon to obtain informed consent